Session 1: Public health nutrition Breast-feeding practices in Ireland

Abstract

Breast-feeding is the superior infant feeding method from birth, with research consistently demonstrating its numerous short-and long-term health benefits for both mother and infant. As a global recommendation the WHO advises that mothers should exclusively breast-feed for the first 6-months of life, thus delaying the introduction of solids during this time. Historically, Irish breast-feeding initiation rates have remained strikingly low in comparison with international data and there has been little improvement in breast-feeding duration rates. There is wide geographical variation in terms of breast-feeding initiation both internationally and in Ireland. Some of these differences in breast-feeding rates may be associated with differing socio-economic characteristics. A recent cross-sectional prospective study of 561 pregnant women attending a Dublin hospital and followed from the antenatal period to 6 months post partum has found that 47 % of the Irish-national mothers initiated breast-feeding, while only 24 % were still offering 'any' breast milk to their infants at 6 weeks. Mothers' positive antenatal feeding intention to breast-feed is indicated as one of the most important independent determinants of initiation and 'any' breast-feeding at 6 weeks, suggesting that the antenatal period should be targeted as an effective time to influence and affect mothers' attitudes and beliefs pertaining to breast-feeding. These results suggest that the 'cultural' barrier towards breast-feeding appears to still prevail in Ireland and consequently an environment that enables women to breast-feed is far from being achieved. Undoubtedly, a shift towards a more positive and accepting breast-feeding culture is required if national breast-feeding rates are to improve. Breast-feeding practices: Initiation determinants: IrelandBreast-feeding is promoted as the optimal mode of infant feeding for both term and preterm infants (1,2) with shortand long-term health benefits also afforded to the mother (3) . While the evidence for the nutritional benefits of breast-feeding is robust, the practice also confers a number of non-nutritional advantages to young infants relating to the protection against acute infections (4,5) , including neonatal enterocolitis (6) , respiratory illness (7) and otitis media (8,9) , as well as enhanced behavioural and physiological development (10) .Particular interest over the past decade in the persisting long-term benefits of breast-feeding during childhood and even adulthood lends further support to the promotion of the practice (2,11) . Well-designed studies using large sample sizes, follow-up to preschool age, and appropriate adjustment for important potential confounding factors suggest a modest protective effect of having been breast-fed on later obesity risk (12)(13)(14) . Research is also emerging to indicate a link between early feeding mode and risk for CVD in adulthood via a potential early programming mechanism (15,16) . Breast-fed infants have been shown to have decreased systolic (17) and diasto...

A Comparison of Maternal Attitudes to Breastfeeding in Public and the Association with Breastfeeding Duration in Four European Countries: Results of a Cohort Study

“…Embarrassment is often cited as one of the major reasons for not choosing to breastfeed or for early breastfeeding discontinuation . A society that is perceived by women to disapprove of breastfeeding in public is not conducive to prolonged breastfeeding.…”

Early initiation of breastfeeding among mothers of children under the age of 24 months in Southern Ethiopia

“…Predicting factors for EIBF include: place of residence and delivery [12]; postnatal care and educational status [9]; unemployment benefit, social welfare and household income [13]; maternal age and socioeconomic status [14]; marital status, smoking, breastfeeding exposure [15]; parity [16]; and antenatal care [17]. Conversely, a prospective study done in India discovered parental education, living condition, number of antenatal visits, birthweight, cultural habit of the population, postnatal breastfeeding advice, previous breastfeeding exposure, and mother’s employment had no significant association with EIBF [18].…”

Social and demographic determinants for breastfeeding in a rural, suburban and city area of South East China

“…The literature, however, suggests that predictors of breastfeeding may vary in different parts of the world. For instance, studies in Australia, Iceland, Ireland, Scotland, as well as the USA have found that breastfeeding rates are higher among women who are older and have higher levels of education (Baghurst et al, 2007; Cairney & Barbour, 2007; Tarrant & Kearney, 2008; Taylor, Risica, Geller, Kirtania, & Cabral, 2006; Thome, Alder, & Ramel, 2006). Additionally, higher incomes have also been associated with increased breastfeeding rates in areas such as Sweden (Wallby & Hjern, 2009), and rural Jamaica (Chatman et al, 2004).…”